• 


GOT   '      r 


THE  GREAT  WHITE  PLAGUE 

SIMPLE 
LESSONS  ON 
CAUSES  AND 
PREVENTION 

BY 

W.  D.  FROST  AND  M.  V.  O'SHEA 


ISSUED  BY 

c.  P.  GARY,  STATE  SUPERINTENDENT 

-- 


MADISON,  WISCONSIN 

DEMOCBAT  PRINTING  COMPANY,  STATE  PBINTEB 

1912 


BACILLUS  TUBERCULOSIS. 


?:iv.     '>':- 
'•:.:-<_    :£.-. 

"  'v  '•••':•*."- 


The  germs  of  tuberculosis  from  the  spit  of  a  consumptive  as 
they  appear  under  the  highest  powers  of  a  compound  microscope. 
Each  little  red  rod  is  a  separate  individual  and  capable  of  pro- 
ducing the  disease  under  favorable  conditions. 


THE  GREAT  WHITE  PLAGUE 


Simple  Lessons  on  Causes  and 
Prevention 


INTKXDKD  KSi>I-:CIALLV  FOR  TSK  IX  SCHOOLS 


uy 


W.     D.     JROST 

of  tlic  Department  of  Bacteriology 

AND 

M      V.     O  '  S  H  E  A 

of   the  Dfirirtment  of  Education 

IN    THE    UNIVERSITY   OF    WISCONSIN 


[SSUED    I ;  V 

C.   P.  GARY 

STATE     SITKIMNTKNDKNT 


MADISON 

DE.MOI  HAT  PKIXTIXJ;  ('OMI-ANY,  STATE  PRINTER 
1912 


Copyright,  1912,  by 

W.    D.   FROST  AND  M.   V.   O'SHEA 

Madison,   Wis. 


TABLE  OF, CONTENTS. 


Page 

•  \  I.  Minute  Forms  of  Life 5 

LESSON  II.  The  Work  of  Microbes 8 

\  III.  Microbes  Produce  Disease 10 

\  I V.  The  Germ  of  Tuberculosis 12 

\  V.  The  Nature  of  Tuberculosis 15 

LESSON  VI.  The  Extent  of  Tuberculosis 1? 

Lns-ioN  VII.  The  Spread  of  Tuberculosis 22 

x*  VIII.  Means  of  Preventing  Tuberculosis 26 

\  IX.  Means  of  Preventing  Tuberculosis  (Concluded) 30 

\  X.  j  j  Developing  Resistance  to  Disease 38 

>\  XI.  Tuberculosis  a  Curable  Disease 45 


264298 


PEEFACE 


This  little  book  is  intended  for  pupils  from  the  age  of  twelve 
or  thirteen  years  onward.  It  has  been  the  aim  to  make  the 
material  contained  in  it  of  practical  interest  to  teachers  as  well 
as  to  pupils.  The  treatment  throughout  is  simple  and  concrete, 
and  every  principle  developed  is  illustrated  with  instances  drawn 
from  the  every-day  experiences  of  children  of  the  ages  for  whom 
the  book  has  been  prepared.  Generous  use  has  been  made  of 
photographs  and  diagrammatic  pictures. 

If  the  pupils  now  in  the  schools  could  be  so  instructed  in  re- 
spect to  the  subject  matter  of  this  book  that  it  would  take  effect 
in  their  daily  living,  tuberculosis  would  be  materially  dimin- 
ished immediately;  and  in  a  generation  or  two  it  would  prob- 
ably disappear  completely.  It  is  doubtful  if  it  can  be  got  rid 
of  in  any  other  way. 

The  'authors  have  had  the  co-operation  of  the  WISCONSIN  ANTI- 
TUBERCULOSIS  ASSOCIATION  in  the  preparation  of  the  book;  and 
acknowledgment  is  hereby  made  of  valuable  financial  help  as 
well  as  criticisms  and  suggestions  made  by  the  officers  of  the 
Association.  Acknowledgment  is  also  made  of  assistance  re- 
ceived from  Superintendent  C.  P.  Gary,  and  from  Professor 
W.  E.  Leonard,  Miss  M.  E.  Ashmun  and  Mrs.  E.  E.  Hoyt  of  the 
University  of  Wisconsin. 

Madison,  Wis.,  March,  1912. 

THE  AUTHORS. 


THE  GREAT  WHITE  PLAGUE. 


LESSON  I.     MINUTE  FORMS  OF  LIFE. 

You  have  all  seen  India  ink,  and  you  know  ho\v  black  it  is; 
but  do  you  know  that  its  blackness  is  due  to  very  fine  particles  of 
the  ink  so  small  that  they  cannot  be  seen  with  the  naked  eye? 
When  they  are  seen  under  the  microscope  they  look  like  pieces 
of  coal. 

We  cannot  see  the  moisture  in  the  atmosphere,  and  yet  we 
know  it  is  there,  else  we  could  have  no  rain  or  snow. 

Although  everyone  is  familiar  with  many  kinds  of  plants  and 
animals  differing  as  to  size,  some  people  do  not  realize  that  there 
are  a  great  many  forms  of  life  so  small  that  they  cannot  be  seen 
with  the  naked  eye. 

Mention  all  the  forms  of  life  you  know  which  are  so  small 
that  you  cannot  see  the  individuals,  although  you  can  observe 
masses  of  them  when  they  multiply  into  billions.  How  can  you 
tell  that  there  are  individuals  in  these  masses?  You  should 
make  a  few  experiments  to  show  that  there  are  very  minute  living 
things  that  will  do  work  which  we  can  observe  when  the  condi- 
tions are  right. 

In  an  ordinary  compressed  yeast  cake  there  are  billions  of 
living  cells,  or  plants,  that  are  called  yeast  plants.  These  cells  are 
so  small  that  we  cannot  see  the  individuals  without  a  microscope, 
but  we  can  see  the  work  which  masses  of  them  do  working  to- 
gether. Everyone  is  familiar  with  the  "raising"  of  bread  when 
yeast  is  put  into  it.  Anyone  can  show  the  working  of  yeast  by 
putting  a  few  teaspoonfuls  of  sugar  into  a  tumbler  of  warm 
water — just  warm  enough  to  hold  the  finger  in — and  then 
crumbling  into  this  a  considerable  portion  of  a  compressed  yeast 
cake.  In  a  little  while,  the  yeast  cells  or  plants  will  begin  to 
work,  and  soon  gas  will  be  seen  escaping,  with  the  appearance  of 
a  frothy  scum  on  the  surface.  These  changes  are  due  to  the  activ- 


:   OB  THE  GREAT  WHITE  PLAGUE. 


ity  of  the  yeast  cells,  which  break  up  the  sugar,  forming  alchohol 
and  carbonic  acid  gas.  It  is  this  gas  which  we  see  rising  in 
bubbles. 

Minute,  invisible  forms  of  life  exist  everywhere  about  us. 
They  are  so  small  that  they  cannot  be  seen  by  the  naked  eye, 
but  if  they  fall  upon  a  suitable  food  such  as  the  cut  surface  of  a 
boiled  potato,  or  a  slice  of  moist  bread  or  cheese,  they  will  in- 
crease in  number  so  rapidly  that  in  a  few  days  they  will  form 
spots  or  "colonies"  which  are  easily  visible.  The  air  always  con- 
tains a  greater  or  smaller  number  of  these  invisible  forms  of  life, 
but,  fortunately,  they  are  usually  not  harmful. 


Fii?.  1. — Yeast  cells  as  seen  under  a  very  power- 
ful  microscope. 

Have  you  observed  what  happens  to  meat,  milk,  or  almost  any 
other  article  of  food,  if  it  is  left  exposed  to  warm,  moist  air? 
Describe  what  happens.  Why  do  people  boil  milk  to  keep  it  from 
' '  spoiling  ? ' '  Wliy  will  cooked  meat  keep  longer  than  raw  meat  ? 
Why  do  people,  when  they  can  cherries,  pears,  or  other  fruits, 
try  to  make  the  cans  air-tight  ?  What  will  happen  if  they  do  not 
do  so? 

Our  forefathers  from  remote  times  until  a  few  decades  ago  lived 
without  having  clearly  understood  that  there  are  vast  num- 
bers of  both  plants  and  animals  so  minute  that  one  can  see  them 
only  with  the  aid  of  a  powerful  magnifying  glass.  But  when  the 
microscope  was  perfected,  people  began  to  understand  that  there 
is  a  world  of  living  things  of  which  many  have  never  even  dream- 


Si.Mi-i.i:    LESSONS   ON    CAUSES    AND    PKKVKNTION.  7 

ed.  Some  one  li;is  spoken  of  this  newly  discovered  world  as  that 
of  the  "infinitely  little.''  And  as  we  have  come  to  know  more 
about  these  inirrosropir  phmls  and  animals,  we  have  come  to  real- 
ize how  important  they  are.  They  do  much  of  our  work,  such  as 
preparing  our  food,  carrying  off  and  destroying  our  waste  mat- 
erial, and  performing  other  necessary  and  useful  tasks.  Some  of 
them  are  our  friends.  They  ripen  our  cream  for  butter-making, 
cure  our  cheese,  make  our  vinegar;  they  purify  our  sewage  and 
disintegrate  our  garbage ;  they  keep  the  soil  fertile,  etc.  Many  of 
them,  however,  are  our  enemies;  and  the  fact  that  they  produce 
diseases  of  different  sorts  is  one  reason  why  we  have  become  so 
much  interested  in  them,  and  why  we  are  trying  to  discover 
under  what  conditions  they  grow,  and  how  we  can  control  them. 
The  forms  of  life  we  are  to  study  about  are  altogether  too 
small  to  see  without  the  help  of  a  large  and  expensive  micro- 
scope; and  unless  we  can  use  this  instrument,  the  only  way  in 
which  we  can  learn  anything  about  these  minute  bodies  is  to 
observe  the  work  which  they  do. 


TUBERCULOSIS:    OR  THE  GREAT  WHITE  PLAGUE. 


LESSON  II.     THE  WORK  OF  MICROBES. 

Bring  from  your  home,  or  secure  from  a  grocery  store,  a  rotten 
apple  and  a  rotten  potato,  and  also  a  few  sound  ones  of  each  va- 
riety. Your  teacher  will  then  place  the  rotten  apple  on  a  table  or 
shelf,  and,  close  to  it  and  touching  it,  a  sound  apple.  Place  an- 
other sound  apple  near  the  diseased  one,  but  not  touching  it. 
Wrap  another  apple  in  a  piece  of  paper  (waxed  paper,  if  you  can 
get  it),  and  put  this  so  that  the  paper  touches  the  rotten 
apple.  Do  the  same  thing  with  the  potato  and  note  what  hap- 
pens. 

You  will  need  to  make  observations  in  this  experiment  for  about 
one  week.  After  this  time,  describe  what  has  happened  to  the 
apple  or  potato  in  contact  with  the  rotten  ones.  Has  the  same 
thing  happened  to  the  one  near  but  not  touching  the  rotten  one  ? 
Has  the  paper  served  as  a  means  of  protecting  the  apple  or 
potato  from  decay?  What  does  this  experiment  show  in  regard 
to  the  way  in  which  decay  in  fruit  and  vegetables  is  spread? 
Is  decay  catching?  Why? 

Secure  some  moldy  fruit  or  vegetable,  or  a  piece  of  moldy 
cheese,  and  allow  it  to  dry  so  that  it  can  be  pulverized.  Then 
take  some  fresh  bread  and  cut  several  slices.  This  latter  work 
ought  to  be  done  in  a  separate  place  from  that  in  which  the  moldy 
food  is  handled;  it  ought  also  to  be  done  by  a  different  person 
from  the  one  who  prepares  the  molds.  Why  ?  Place  each  of  three 
slices  of  the  fresh  bread  on  a  sheet  of  blotting  paper,  and  on  two 
pirct  s  <;i'  ll'c  bread  sprinkle1  a  small  quantity  of  the  moM  dust. 
Cover  one  of  these  with  a  glass  bowl,  or  some  other  glass  dish. 
The  third  "unseeded"  piece  should  also  be  covered  with  a  glass. 
Those  pieces  which  are  covered  should  be  kept  moist  by  placing 
water  on  the  blotter  from  time  to  time.  Keep  track  of  develop- 
ments for  a  few  days.  At  the  end  of  this  period  describe  what 
change  has  taken  place  on  the  uncovered  piece  of  bread.  What 
was  the  object  in  covering  the  bread  ?  Note  that  the  molds  do  not 
grow  unless  they  have  been  seeded.  If  a  few  molds  do  grow  on 
the  third  piece  of  bread,  it  simply  means  that  the  mold  "seeds" 
or  "spores"  fell  on  it  from  the  air  before  it  was  covered;  note 


SI.MI-I.I-:    LESSONS   ON    CAUSES    \M>    I'KKVI.NTION.  !) 

also  that  of  the  two  pieces  of  bread  seeded  with  mold,  only  the 
mic  that  was  kept  nmist  deveh  ped  a  heavy  erop.:": 

.Many  kinds  of  mirmlns,  or  tiny  invisih'e  forms  of  life,  do  a 
gieat  deal  of  good  for  us.  and  it  would  he  quite  impossible,  or 
at  lea-t  very  inconvenient,  to  get  along  without  them.  l>iit  mi- 
ciohes  are  known  chiefly  for  the  harm  they  d:i.  since  in  many 
ways  they  interfere  \\ith  cur  "happiness.  The  decay  of  fruit, 
vegetables,  and  other  food  products  is  an  undesirable  chang.' 
which  microbes  produce,  and  with  which  we  are  all  familiar 
You  have  already  seen  the  experiments  with  a  n.-iten  apple  or 
potato.  If  we  suffered  the  loss  of  a  single  apple  or  potato  occa- 
sionally we  should  not  mind  it  much;  but  in  our  experiment  \\" 
discovered  that  when  one  apple  becomes  diseased,  the  perfectly 
siaind  apples  around  it  will  so;:n  decay,  first  oil  the  side  which  is 
in  contact  with  the  bad  apple,  and  then  all  the  way  through.  A\V 
know  very  well  that  if  we  leave  a  decayed  apple  in  a  basket  or 
barrel,  it  will  not  be  a  very  long  time  before  all  tbe  neighboring 

apples  will  become  diseased.  'Flic  microbes  which  produce  these 
changes  pass  directly  from  cue  apple  to  another  when  the  apple> 
touch.  The  same  tiling  is  true  of  potatoes:  whenever  we  find  ;: 
lot  ten  potato  in  the  bin,  we  always  throw  it  out  to  prevent  the 
rottenness  from  spreading. 

In  somewhat  the  same  way  that  micrtl  es  produce  derav  and 
rottenness  in  fruits  and  vegetables  special  sorts  of  microbes 
produce  diseases  in  man  and  animals.  We  have  heard  of  "con- 
tagions'' or  "catching"  diseases.  AVc  know  that  a  person  who 
has  smallpox,  measles,  or  whooping  cough  is  being  attacked  by 
microbes,  and  just  as  microbes  may  pjiss  from  one  apple  1o  an- 
other in  a  barrel,  so  smallpox,  measles,  and  scarlet  fever  may  pass 
from  cue  person  1o  another,  or  from  Hie  sick  to  Hie  well. 

Have  you  ever  seen  a  house  with  a  colored  placard  on  the  door 
bearing  the  words  "Scarlet  Fever,"  or  "Diphtheii;i."  or  "Small- 
Why  wnsthe  placard  placed  <  n  the  house.'  (Yuld  people 
come  and  «ro  in  that  house  as  1  hey  chose  .'  AVhy  .' 


*  In  explaining  why  these  things  an  true  the  teacher  can  bring  out 
the  importance  of  environmental  cond'tions,  such  as,  rir  space, 
amount  of  light,  moisture  and  dust. 


10 


Tu:KK(TLOSlS:     OR   T'lIE    GREAT   WlIlTE   PLAGUE. 


LESSON  III.    MICROBES  PRODUCE  DISEASE. 


In  a  good  many  cases  we  do  not  know  how  the  "germs"  or 
microbes  of  disease  pass  from  one  person  to  another.  But  we  do 
know  that  in  some  way,  whether  by  way  of  the  mouth,  or  the  nose, 

or  the  skin,  they  do  leave  the 
sick  body  and  in  some  man- 
ner, either  through  the  air  we 
breathe,  or  the  food  we  eat,  or 
through  the  skin,  they  do  en- 
ter the  bodies  of  healthy  peo- 
ple. Diseases  of  this  kind  are 


spoken  of  as  "infectious"  or 


Fi.tr.  -. — Pasteur — One  of  the  greatest 
benefactors  of  the  human  race.  He 
said  "It  is  within  the  power  of  man 
to  make  Ihe  germ  diseases  disappear 
from  the  world." 


IHptlX    fc  "contagious"  diseases.    They 

are  produced  by  microbes, 
without  which  they  would  not 
exist. 

Microbes  produce  disease 
in  man  and  animals  in  two 
different  ways.  One  class 
grows  in  our  food  materials 
and  produces  poison.  When 
these  poisons  are  taken  into 
the  stomach  with  food,  they 
may  produce  sickness  or 
even  death.  These  poisons 

are  known  as  "ptomaines."  Instances  of  "ptomaine  poisoning 
are  frequently  noticed  in  the  newspapers.  The  dangers  of  pto- 
maine poisoning  can  be  avoided  by  protecting  food  materials, 
especially  meats,  from  the  growth  in  them  of  the  "putrefaction" 
or  decay  microbes  or  "bacteria." 

Microbes,  however,  usually  produce  disease  in  man  and  animals 
by  growing  in  the  body  of  their  victim.  They  live  upon  the  ma- 
terial of  which  the  body  is  made.  From  this  flesh  and  blood  they 
make  poisons  which  cause  sickness  and  death.  These  microbes 
are  "parasites."  (What  is  a  parasite?)  Diseases  caused  in  this 
way  are  spoken  of  as  "germ"  diseases.  To  these  diseases,  also,  the 
terms  "contagious,"  "infectious,"  and  "preventable"  are  given 
for  reasons  to  be  explained  later. 


SIMI-LH  LKSSONS  ON  CArsi-:s   AND   PBEVENTION,  11 

A  particular  germ  is  always  the  cause  of  a  particular  disc  ige, 
These  Drills  are  usually  named  al'ler  the  diseases  which  they  pro- 
duce,  as  the  "diphtheria"  germ,  the  "typhoid''  germ,  or  the 
"tuberculosis"  germ.  People  never  have  t  hese  diseases  unless  the 
particular  germ  which  causes  them  is  growing  in  and  poisoning 
the  body.  The  disease  germs  always  come  from  parent  germs,  and 
never  start  from  "nothing"  as  some  people  used  to  think,  or  from 
the  body  itself.  These  germs  always  come  from  some  previous 
case  of  the  disea>e  which  they  produce.  Certain  of  these  dis-.-as.  s 
are  "caught"  by  one's  coming  into  contact  with  some  one  having 
the  disease.  For  this  reason  they  are  called  "contagious" 
i  touched;  carried).  Decay  or  rottenness  in  fruit  or  vegetables 
is  produced  in  the  same  way,  you  will  remember.  Some  other 
get  in  diseases  are  carried  indirectly  from  the  sick  to  the  healthy  ; 
as.  Tor  example,  through  food  or  drink,  as  milk  or  water;  and 
by  means  of  insects,  as  flies  and  mosquitoes.  These  are  called 
"infectious"  diseases.  There  is  no  sharp  distinction  between  in- 
fectious and  contagious  diseases.  All  contagious  diseases  are  in- 
fect ious,  but  infectious  diseases  are  not  necessarily  contagious. 
Why! 

Probably  all  of  these  diseases  can  be  prevented.  All  that  is 
necessary  is  to  prevent  the  escape  of  the  disease  germ  from  those 
infected  by  it,  and  guard  the  bodies  of  the  well  from  its  attack. 

Among  the  diseases  produced  by  microbes  none  is  more  impor- 
tant or  dreadful  than  "tuberculosis."1  The  presence  of  tubercu 
losis  in  a  family  or  community  is  dangerous,  in  somewhat  the 
same  way  that  a  rotten  apple  in  a  basket  is  dangerous  to  all  the 
good  apples.  But  there  is  this  difference :  it  is  practically  impos- 
sibe  to  make  a  rotten  apple  safe  to  put  with  the  sound  ones.  But 
in  the  case  of  tuberculosis  and  other  diseases  due  to  microbes  or 
germs,  when  intelligent  care  is  used,  people  suffering  from  them 
may  with  a  certain  degree  of  safety  mingle  with  well  people.  But 
it  must  always  be  remembered  that  a  person  suffering  from  a 
germ  disease  is  dangerous  to  the  people  around  him  unless  every- 
body is  very  careful  to  prevent  the  escape  of  the  dangerous 
germs  from  the  diseased  person,  and  the  entrance  of  these  germs 
into  the  body  of  some  one  else. 


12 


TUBERCULOSIS:    OR  THE  GREAT  WHITE  PLAGUE. 


LESSON  IV.     THE  GERM  OF  TUBERCULOSIS. 


Expose  a  gelatine  or  agar  plate*  to  the  air  for  a  few  minutes, 
then  cover  it  up,  and  allow  it  to  grow  for  several  days.  Growths 
will  appear  in  the  form  of  "colonies."  Each  colony  represents 

the  decendants  cf  a  s'ng'e 
germ  which  fell  on  the  plate. 
Count  the  number  of  colo- 
nies, and,  knowing  the  area 
of  the  plate  and  the  number 
cf  minutes  it  was  exposed 
figure  out  the  number 
of  bacteria  that  were  falling 
in  the  room  per  square  foot 
per  hour.f  Draw  some  of  the 
colonies.  If  possible,  exam- 
ine some  of  these  germs  or 
mircobes  or  bacteria  under 
the  microscope,  and  draw 
what  you  see.  Perhaps  your 
teacher  will  give  you  one  of 
these  plates  to  expose  at 
home.  When  the  colonies 
have  grown  out,  count  them 
and  then  examine  them  under  the  microscope. 

Until  late  years  nothing  was  known  in  regard  to  the  cause  of 
tuberculosis.  It  was  only  about  the  middle  of  the  last  century 
that  the  disease  was  definitely  considered  as  an  infectious  dis- 
ease. Our  ancestors  thought  that  it  was  due  entirely  to  "hered- 
ity;" that  is,  that  children  were  born  with  it.  The  credit  of 
discovering  the  cause  of  tuberculosis  belongs  to  Robert  Koch,  of 
Germany.  The  discovery  was  announced  in  1882.  At  the  time 
Robert  Koch  made  his  discovery,  scientists  were  just  becoming 


Fig.      3. — Robert      Koch— This      picture 
was   taken  of   him  at  about   the   time* 
he   discovered   the   "tubercle    bacillus." 


*  These  cannot  be  prepared  except  by  those'  who  have  had  special 
training  in  bacteriology,  but  the  necessary  material  will  be  furnished 
for  this  experiment,  accompanied  by  full  directions  for  use.  These 
experiments  add  much  to  the  interest  of  the  work.  Write'  to  the  De- 
partment of  Bacteriology  and  Hygiene,  University  of  Wisconsin. 

t  For  example,  if  the  plate  has  an  area  of  12  square  inches  and  de- 
velops 20  colonies  when  exposed  20  minutes  the  rate  of  falling  would 
be  12  times  20  or  240  per  foot  each  20  minutes,  or  3  x  240,  or  720 
per  hour. 


SIM  I'M-:    LESSONS   ON    CAUSES    AND    PIJKVKNTION.  13 

;i.-«|ii;iint.'(l  with  tin-  various  disease  germs  or  "bacteria."  IJac- 
feria,  as  you  have  learned,  an-  t'nniis  of  j)lant  life  in  which  the 
individuals  are  so  e\t remely  small,  thai  they  an-  invisible.  In 
measuring  them  we  use,  as  the  unit  of  measurement,  what  is 
kn..\\ii  as  a  micmn.  which  is  about  1/25000  of  an  inch.  Many  of 
the  bacteria  are  only  about  one  micron  in  length,  and  rarely  are 
they  more  than  a  micron  in  width.  This  means  that  250  of  such 
bacteria  placed  end  to  end  would  about  equal  the  thickness  of  a 
piece  of  the  paper  on  which  this  book  is  printed. 

DitVerent  bacteria  vary  in  shape,  from  spheres  through  the 
cylindrical  forms,  to  twisted  cylinders,  or  corkscrew  forms. 
The  "bacillus"  or  germ  of  tuberculosis  is  a  straight,  narrow 
rod.  about  half  a  micron  wide,  and  five  or  six  microns  long. 
.Many  kinds  of  bacteria  can  be  grown  artificially  on  food  sub- 
stances made  from  meat.  A  broth  made  very  much  like  a  beef 
consomme  is  frequently  used.  To  this  may  be  added  a  gelatine  or 
auar  (a  vegetable  gelatine),  and  in  these  substances,  or  media, 
as  the  scientists  say,  most  bacteria  grow  readily.  The  bacillus 
of  tuberculosis,  however,  is  a  very  dainty  microbe,  and  it  will 
not  grow  in  the  media  named  above'  unless  a  little  glycerine  is 
added,  in  which  case  it  grows  w^ell,  but  slowly.  It  grows  very 
well  upon  the  fluid  or  watery  part  of  blood,  either  human  or 
animal,  which  has  been  hardened  by  heat.  Except  when  intro- 
duced into  such  media  as  just  mentioned  above,  the  "tubercle 
bacillus"  does  not  grow  outside  of  the  animal  body.  This  is 
very  fortunate  for  us,  because,  if  it  did  increase  in  numbers 
outside  of  the  body,  the  whole  world  of  men  and  animals  woul- 
have  been  affected  long  before  this. 

The  tubercle  bacilli,  or  germs  of  tuberculosis,  which  come 
directly  from  a  sick  patient,  or  from  "cultures"  made  in  the 
way  described  above,  where  it  was  shown  how  to  grow  bacteria 
at  will,  can  be  studied  only  under  the  microscope. 

Because  they  are  extremely  small,  and  also  because  they 
are  almost  transparent  and  without  color,  it  is  very  difficult  to 
study  them.  Ordinarily  they  are  examined  only  when  they 
have  been  specially  treated  or  stained.  When  they  are  viewed 
under  the  miscroscope,  they  present  a  characteristic  appearance. 
The  fact  that  the  tubercle  bacillus  takes  a  stain  of  its  own, 
makes  it  possible  for  those  trained  to  the  task  to  tell  this  germ 
from  all  others  which  may  he-  somewhat  like  it.  The  sputum 
(or spit)  of  a  person  who  has  tuberculosis  contains  these  germs, 


14 


TUBERCULOSIS:    OR  THE  GREAT  WHITE  PLAGUE. 


sometimes  in  very  great  numbers.  By  staining  this  material 
and  examining  it  under  the  miscroscope,  it  is  usually  possible 
to  early  find  the  germ  of  tuberculosis.  Everyone  who  suspects 
that  the  disease  may  have  fastened  itself  upon  him  should  have 
his  sputum  examined.  Many  states,  and  some  of  the  cities  of 
the  country,  have  dispensaries  or  laboratories  where  this  kind 
of  work  is  done  without  charge. 

Although  the  germ  of  tuberculosis  does  not  grow  and  repro- 
duce outside  of  the  body,  except  on  special  "culture  media," 
still  it  does  live  outside  the  body  sometimes  for  very  long  periods, 
simply  retaining  its  vitality,  ready  to  grow  when  the  conditions 
are  right.  This  germ  can  withstand  drying  for  months  and  even 
years.  It  may  live  in  putrefying  (rotting)  or  decaying  material 
for  a  long  time,  and  in  dark,  dirty  corners  of  buildings  for  years. 
One  of  the  best  ways  of  killing  it  is  to  allow  the  direct  sunlight- 
to  reach  it.  It  will  be  killed  also  more  quickly  in  a  dry  than  in 
a  mcist  place.  Hence,  the  necessity  of  dry,  well-ventilated, 
and  light  rooms. 


FINDING  SEEDS  IN 
SPUTUM   OR  SPIT' 


Fig.   4. — Tho  gorm  of  tuberculosis, 
last  page  of  cover. 


See 


DOCTOR  EXAMINING  CHEST 

j) LOCATING  SOLID  POKHOMS  ifuSTENING  TO  SOUNDS 
A3  CARPENTER  SOUNDS      MADE   BY  AIR  IN 
JOISTS  IK  PLASTER  WALL  Hi  THE  L.UNGS        — « 

CHEST  MUST  BE  BARE* 


Fig.  5. — Doctor  examining  the  chest  of 
a  person  suspected  of  having  tuber- 
culosis. 


i.i:  LESSONS  ON  CAUSES  AND  PREVENTION. 


15 


ON   V.     TIIK  XATCU'K  OP  TUBERCULOSIS. 

Nearly  everyone  h;is  seen  people  who  were  thin,  with  hollow 
cheeks  and  narrow  diesis,  and  who  had  a  dry,  hacking  cough. 
Sneli  people  are  sometimes  said  to  be  suffering  from  "bron- 
ehilis;"  but  it'  the1  truth  is  known,  it  sooner  or  later  appears 
that  they  have  consumption,  or  tuberculosis  of  the  lungs. 
There  are  few  people  who  have  not  seen  hunchbacks.  These 
people  have  deformed  spinal  columns  which  have  been  injured 
and  twisted  on  account  of  a  diseased  condition.  This  is  usually 
the  result  of  tuberculosis.  Hip  joint  disease  is  common.  On 
account  of  disease,  the  hip  has  been  deformed,  and  the  hip 
joint  stiffened  so  that  it  can  not  be  moved.  If  we  knew  the 
history  of  these  cases,  we  should  find  that  almost  always  this 
injury  to  the  hip  joint  had  been  brought  about  by  tuberculosis 
Diseases  of  the  bones  in  other  parts  of  the  body  are  frequently 
caused  by  tuberculosis.  Frequently,  especially  in  children,  dis- 
eases of  the  intestines,  which  are  serious  and  difficult  to  treat, 
are  caused  by  tulierculosis. 

We  have  already  noticed  that  tuberculosis  is  a  disease  caused 
by  the  growth  in  the1  body  of  a  germ  or  microbe  known  as  the 


g.    0. — The    little    bunches   or   "nodules"    are   the    "tubercles" 

formed   on    11i->    inside   of  ;i    cow   with   tuberculosis.      In    health 
this    "oiuentinn"    is    smooth. 


16 


TUBERCULOSIS:    OR  THE  GREAT  WHITE  PLAGUE. 


Bacillus  lulu  rciilosis.  When  the  germ  gets  into  the  body,  ii. 
grows  in  the  tissue,  destroying  the  cells  all  around  it.  It  also 
makes  certain  other  cells  grow  causing  the  production  of  "nod- 
ules" or  "tubercles."  These  are  shown  in  the  accompanying 
illustration.  This  formation  of  "tubercles"  is  peculiar  to  this 
disease,  and  has  given  it  the  name  tuberculosis.  Hi's  gem; 
ihay  grow  in  any  part  of  the  body;  but  in  human  beings  it  grows 
iin-1  frequently  in  the  lungs.  When  tuberculosis  occurs  in  the 
lungs,  and  especially  after  the  disease  has  gone1  on  for  some 
lime,  it  is  known  as  consumption.  In  the  United  States,  about 
nine  people  die  of  consumption,  where  one1  dies  from  some 
other  form  of  tuberculosis;  so  that  consumption  is  by  far  the 
most  important  form  of  this  disease.  A  great  many  people 
suffer  from  various  other  forms  of  the'  disease,  however ;  and 
children  especially  are  likely  to  have  the  disease  in  the  intes- 
tines, or  in  the  spinal  column,  or  in  the  hip  joint  or  other  bones, 
or  in  the  glands  of  the  neck  and  so  on.  In  times  past,  these 
diseases  went  under  different  names,  but  whether  the  tubercle- 
bacillus  attacks  the  parts  of  the  body  named  above,  or  the  brain, 
the  spinal  cord,  or  any  other  part,  it  is  in  reality  one  and  the 
same'  disease,  and  is  caused  by  the  same  microbe. 


VOLUNTEERSWANTED- 
MEN,WOMEN,CHILDREN. 

V\£.   7.   —The   appeal    is   to   all    of    us. 


SIMM. i     I.  ON    CAUSES   AND    I'KIA  i:vn<>.\. 


17 


ON  VI.     Till-:  ]<;XT1-;\T  OK  TUBERCULOSIS. 

What  is  the  most  frequent  cause  of  sickness  and  death.' 
This  is  a  (jiicslion  any  one  mi^ht  well  ask.  If  yon  were  1:)  go 
to  the  health  officer  in  your  city  or  town,  and  ask  hint  what 
was  the  chief'  cause  of  death  in  your  community,  the  reply  would 
ordinarily  he,  "Tuherculosis."  If  your  health  officer  had  a 
record  of  the  living  cases  of  tuherculcsis.  as  he  certainly  ough; 
to  have,  he  would  tell  you  that  then-  fire  far  more  cases  of 
tuherciilosis  than  of  any  other  disease;  and  at  any  one  lime 
(here  would  prohahly  he  more  cases  ot  tuherciilosis  than  there 
were  cases  of  all  other  infectious  or  «rcnn  diseases  lowlier. 
So  that  it  is  fair  to  say  that  tuherculcsis  is  the  greatest 
plague  with  which  the  human  race  is  afflicted,  hecause  of  all 
diseases  common  to  mankind,  it  is  the  must  widespread  and 


6333~  Scarlet  Fever 

12,866 

Measles 


'(0 


in 


35,379 
Typhoid  Fever 


Diphth 


eria 


9,958 
Whooping  Cough 

16,645 
Influenza 


Fi-r.   S.  -  -This  fi.mire  shows  II';, I    liibereiiinsis   is   more   dcndly    ih;m    Bear 
h-t    fever,    measles.    iypli«.id    fever,    dipli |  Iieria.    whooping    eolith    and 
cumbined.      1".    S.   Cinsiis    1:    port. 


18 


TUBERCULOSIS:    OK  THE  UREAT  WHITE  PLAGUE. 


the  most  deadly.  John  Bunyan  spoke  of  it  as  the  "Captain  of 
the  Men  of  Death."  It  causes  more  deaths  each  year  than 
scarlet  fever,  measles,  typhoid  fever,  diphtheria,  whooping 
cough,  and  influenza  combined.  Study  the  chart  and  see  how 
this  fact  is  shown.  We  think  of  the  terrible  loss  of  life  due  to 
war,  but  tuberculosis  kills  many  more  people  than  war  ever  has 
done ;  and  it  always  keeps  on  with  its  work.  It  never  grants  a 
truce.  The  entire  loss  of  life  in  the  Franco-Prussian  war  was 
only  about  one-half  the  loss  from  tuberculosis  in  Prussia  alone 
for  a  single  year.  The  loss  of  life  in  our  country,  due  to  tuber- 
culosis, in  any  four  years,  is  about  three  times  the  loss  of  men 
during  the  four  years  of  the  Civil  War. 

.  In  the  nineteenth  century  there  were"  many  terrible  wars, 
and  it  is  estimated  that  fourteen  million  soldiers  died  on  the 
battle  field.  But  while  these  wars  were  going  on,  thirty  mil- 


COMPARISON 

Of 

Of  ATMS  fROM  C/VtLWAR 
tv/r/t 


UvtrcD  Srsrrs 

OWL  WAR  - 


IN  ACT'  OH 
D/£O   FffOM  WOUHOS. 

FEDERAL  -  -/'OOOO 


TOTAL  •  -  •  3O5OOO 

\COHSUMPTION 

FOUR  YEARS. 

S9O4-/907 

644.000. 


9*9.90* 

Fig.  0. — The  banded  object,  at 
the  left,  represents  a  germ 
of  tuberculosis.  It  appears 
more  than  three  times  as 
long  as  the  gun  and  this 
represents  the  relative  de- 
structiveness  of  this  germ 
as  compared  with  the  gun 
in  war  time.  We  must  re- 
member that  this  germ  is 
destroying  its  victims  all 
of  the  time,  and  not  merely 
during  war  time. 


12,500  \ 


Fig.  30. — About  as  many  people  die  in 
Wisconsin  each  year  from  tuberculo- 
sis as  there  are  soldiers  in  the  State 
Guard.  There  are  at  least  six  times 
as  many  living  cases,  probably  ten 
times. 


SI.MI-I.I:  LESSONS  ON   CAUSES   \.M>  PREVENTION, 


19 


limi  people  iii  flu-  very  same  countries  died  of  tuberculosis.  The 
number  of  deaths  in  the  San  Francisco  earthquake  was  only  a 
little  over  one  half  of  the  loss  of  life  every  year  in  San  Frjnu-isco 
from  tuberculosis.  The  great  earthquake  in  Southern  Italy 

COST  or  TUBEffGULOS/S  /n  THE  Uw  TED  STATES 
V*\L.UE.  or  \A/=f/ou<s 


4C4, 254,703 


472.  £76, 703 


369,945,320 


323,758,171 


Purest  Product; 


217,098,564- 


109,664,774- 


Tobacco         i     56,989,902 
Small  Fruit     i     25,029,757 


Fi;r.  11. — The  length  of  the  linos  indicates  what  tuberculosis  annually  costs  the 
PC  '>].!<>  of  (lie  l'n  i  ted  States  ir»  dollars  in  comparison  \vitli  (he  value  of  vari- 
ous staple  products. 

destroyed  scarcely  more  people  than  die  each  year  of  this  disease 
in  the  United  States.       It  is  estimated  that  from  twenty-five 
hundred  to  three  thousand  people  die  each  year  in  Wisconsin 
from  this  disease.     In  the  United  States  from  one  hundred  and 


20 


TUBERCULOSIS:    OR  THE  GREAT  WHITE  PLAGUE. 


fifty  thousand  to  two  hundred  thousand  die  every  year,  and 
a  million  and  a  half  in  the  wo,rld.  The  terrible  price  we 
have  to  pay  for  the  neglect  of  this  disease  is  impressed  upon 
us  if  we  realize  the  fact  that  of  the  ninety  million  people  now 
living  in  the  United  States  over  nine  million  of  them  will  die 
of  tube'rculosis,  unless  conditions  are  improved ;  and  of  these 
nine  million,  two  hundred  and  fifty  thousand  will  be  in  the 
State  of  Wisconsin. 


YEARLY  LOSSES  FROM 

WBERCUIOSISWEIBUY 


19,500,000          35,000,OOO         44,000,OOO 

OR  OR 

BUSHELS  flT504       BUSHELS  flT4(H 


350000.C4TTLE    350,000,000      40,000  MEN 

OR  OB 

flT*50.PE£  HEAD    LOAVES  AT  5.05       flT  3437.  fl  YEAR 

IN  WISCONSIN 


Fig.  12. 

The  waste  in  dollars  and  cents  caused  by  the  disease  has  been 
estimated  by  a  number  of  people,  and  it  is  probably  fair  to  say 
that  we  lose  in  the  United  States  each  year  one  billion  one 
hundred  million  dollars  ($1,100,000,000)  as  a  result  of  the 
disease  in  human  beings;  and  fourteen  million  ($14,000,000) 
more  as  a  result  of  the  disease  in  cattle.  This  loss  far  exceeds 


SIMPLE   LF»I»\S  ON  CAUSES  AND  I 'INVENTION.  21 

the  value  of  any  one  crop  in  the  Tinted  States.  Or,  in  other 
words,  it'  we  should  lose  one  entire  corn  crop,  and  cotton  crop, 

lull  rould  save  one  yeai  's  loss  from  t  llberculesis.  We  should,  as  a 
nation,  he  financially  hetter  of!'  than  \ve  now  are.  Tin-  loss  of  the 
dairy  products,  the  wheat,  the  forest  products,  the  tobacco,  and 
small  fruit  of  an  entire  year  would  scarcely  exceed  in  value  the 
present  loss  from  lulu  rculoMs.  Besides  the  money  losses  in- 
dicated above,  the  human  nice  has,  of  course,  been  made  very 
much  less  happy  because  of  the  ravages  of  this  disease?  than 
it  otherwise  would  have  been.  It  has  caused  poverty  and  suf- 
fering beyond  anything  that  can  be  measured.  It  has  been 
the  direct  or  indirect  cause  of  filling  our  insane  hospitals  and 
orphan  asylums,  our  homes  and  hospitals  for  crippled  children, 
our  reformatories,  and  our  prisons  and  penitentiaries.  It  has 
deprived  us  at  an  early  age  of  many  of  the  most  brilliant  men 
and  women  in  all  periods  of  the  world's  progress. 


If  we  had  through  the  misfortunes  of  war,  or  the  sudden 
rise  of  pestilence,  or  through  some  awful  calamity,  the  de- 
struction of  life  that  annually  takes  place  on  account  of  the 
spread  of  the  white  plague,  we  should  be  appalled.  Mass  meet- 
ings would  be  held  in  every  community  and  demand  would  be 
maae  that  the  most  urgent  measures  should  be  adopted.  It 
is  only  because  we  are  accustomed  to  this  waste  of  life  that 
we  can  look  calmly  on  and  go  about  our  business,  paying  no 
attention  to  this  enormous  death  toll,  which  our  American 
people  are  paying. 

— Justice  Charles  E.  Huglics,  U.  S.  Supreme  Court 


22 


TUBERCULOSIS:   OR  THE  GREAT  WHITE  PLAGUE. 


LESSON  VII.     THE  SPREAD  OF  TUBERCULOSIS. 

In  a  preceding  lesson  it  was  shown  that  the1  sputum  (or  spit) 
of  persons  suffering  from  tuberculosis  of  the  lungs  (or  consump- 
tion) may,  and  usually  does,  contain  the  bacilli  or  germs  of 
tuberculosis.  These  germs  may  be  carried  from  one  place  to 
another  through  the  sputum.  These  germs,  in  the  case  of  peo- 
ple suffering  from  tuberculosis,  leave  the  body  almost  entirely 
in  the  sputum.  In  the  case  of  animals  suffering  from  the 
disease,  the  meat  and  milk  may  contain  the  bacilli,  and  hence 


Fig.  13. — The  germs  that  attack  us 
come  from  the  bodies  of  the  sick. 
From  Ritchie's  Hygiene,  published  by 
the  World  Book  Co. 


Fig.  14. — Kiss  the  baby  on  the 
cheek,  not  on  the  mouth.  Why? 
From  Ritchie's  Hygiene  pub- 
lished by  the  World  Book  Co. 


be  the  means  of  spreading  the  disease.  In  the  case  of  both 
man  and  animals,  "pus,"  or  the  matter  coming  from  the  tuber- 
cular sores,  may  serve  as  a  means  of  scattering  the  germs.  It 
is  generally  believed  that  tuberculosis  is  very  largely  passed 
on  from  one  person  to  another  by  means  of  the  sputum.  If 
this  material  is  not  destroyed,  it  dries  and  becomes  pulverized, 
and  is  then  blown  about,  and  may  enter  a  well  person  with  the 
air  that  is  breathed.  It  is  estimated  that  the  sputum  given  off 
in  twenty-four  hours  by  a  person  in  the  last  stages  of  the 
disease  may  contain  as  many  as  seven  billion  tubercle  bacilli 


&I.MIM.I-:  LESSONS  ON   CAUSES  AND  \*\u-.\  I:NTI<»N. 


2:5 


(7,000,000,000).     Considering  the  number  of  careless  consump- 
it  is  no  wonder  that,  the  air  in  certain  buildings,  or  local- 
ities, frequented  by  consumptives,  is  loaded  with  the  .uvrins. 

When  one  talks,  but  especially  when  one  speaks  forcibly, 
roimhs,  o,r  sneezes,  there  is  driven  out  from  the  mouth  a  fine 
spray,  made  up  <>!'  tiny  drops  of  finely  divided  sputum.  These 
droplets  contain,  in  the  case  of  consumptives,  the  germs  of 
tuberculosis;  and  if  these  are  brent  hod  in  by  a  person  inclined 


Fiir.  15. — In  droplets  of  sputum  that  are 
coughed   out  into  the   air,   the  germs 

of    tuberculosis,     infhien/a,    colds    and 
other    respiratory    diseases   are    found. 

towards  the  disease,  they  may  take  up  their  abode  in  him,  and 
grow  vigorously.  However,  the  danger  of  this  is  really  great 
only  when  one  remains  very  near  a  tuberculosis  patient  for  a 
considerable  length  of  time.  At  a  distance  of  three  or  four 
feet  there  is  likely  to  be  but  slight  danger  of  infection.  From 
a  consumptive,  these  little  drops  of  sputum  are  constantly  fall- 
ing on  the  floor  and  the  furniture  and  even  on  food,  and  it  is  im- 
portant that  this  source1  of  danger  should  be  avoided. 

In  the  case  of  tuberculous  ulcers,  abscesses,  etc.,  the  discharge 
contains  the  germ,  and  must  be  carefully  handled  to  prevent 
the  spread  of  the  disease. 

Cows,  even  when  they  have  tuberculosis,  do  not  usually 
cough ;  hence  there  is  little  danger  from  their  sputum.  But 
the  milk  contains  the  tubercle  ge'rms,  not  only  when  the  udder 
is  affected,  as  claimed  a  few  years  ago,  but  also  when  the  in- 
fection exists  in  other  parts  of  the  body.  The  United  States 
Department  of  Agriculture  has  recently  found  that  milk  becomes 
infected  with  disease  germs  by  getting  manure  in  it. 

In  cattle  especially  the  disease  is  located  in  the  internal  organs, 
and  not  in  the  muscles;  hence  the  danger  of  infection  r.y  eating 
meat  from  infected  animals  it  not  so  great  as  it  otherwise  might 


24 


tsis:    OH  THE  GREAT  WHITE  PLAGUE. 


A  CONSUMPTIVE 
CHAIN 


C.    10.—  Noiico 


iin])oriiint    part    that   the    tuberculous    cow    plays   in    this 
chain. 


i;   LESSONS  <»\   CAUSES    \M>  PKKVKNTION.  25 

be1.  Nevertheless,  it  has  been  shown  tli;it  the  J^T:;:S  are  piv^  n! 
in  the  meat  <•!'  c.-ittle  which  have  had  t  ubeivulosis,  and  were 
i«  not  t'oi-  tli.'  fact  Hint  meat  is  usually  cocked  before  it  is  eaten 
thus  killing  tin-  germs,  it  would  In-  a  more  important  ;iiid  dan- 
gerous factor  than  it  usually  is  in  s(n  cadni.u1  the  disense. 

Does  yriir  city  or  town  have  an  "ant  i-spittnii;' '  law.'  IF  so, 
why  was  the  law  made.'  In  what  places  is  it  unlawful  to  spit? 
Why.'  Find  out  whether  or  not  the  law  is  enforced  in  your 
community.  Do  you  see  people  spitting  on  the  street  .'  In 
Mi'eet  cars.  etc.  .'  Copy  an  anti-spitting  placard  which  you  have 

sec  11.        Tell     where    you    S«M\V    it. 

Does  your  city  er  town  have  a  milk  ordinance?  If  so,  does 
ii  require  that  the  cattle  supplying  the  milk  shall  be  tested  for 
tuberculosis .'  Why? 

Try  this  experiment:  Darken  a  room,  and  then  through  a 
pin  hole,  or  other  small  opening,  allow  a  beam  of  direct  sun- 
light to  enter  the  room.  Ask  some-one  so  to  stand  that  he  can 
cough  or  sneeze  right  against  and  along  this  beam  of  light. 
Then  see  if  you  can  delect  the'  fine  spray  of  sputum  which  is 
uiven  off.  Find  out  about  how  far  away  from  the  body  the 
droplets  are  thrown.  Try  also  the  experiment  of  holding  a  mir- 
ror before  the  face  while  speaking. 


26 


TUBERCULOSIS:    OR  THE  GREAT  WHITE  PLAGUE. 


LESSON  VIII.     MEANS  OF  PREVENTING 
TUBERCULOSIS. 

As  we  have  seen,  tuberculosis  is  not  inherited;  but  in  al- 
most all  cases  it  is  taken  by  a  "susceptible"  person  coming 
into  contact  with  some  one  having  the  disease.  The  need  to  re- 
peat for  emphasis,  that  if  we  are  to  prevent  the  spread  of  the 
disease1,  we  need  to  see  that  those  who  have  it  take  proper  care 
of  themselves,  so  that  the  germs  which  they  are  giving  off  do 
not  make  their  way  to  some  one  else.  When  one  is  suffering 
from  consumption,  as  you  have  already  learned,  the  germs  are 
given  off  in  the  sputum  in  enormous  numbers,  and  the  important 
thing  to  do  is  to  prevent  this  sputum  from  drying.  A  consump- 


Pig.  17. — A  pocket  spit  cup 
for  the  use  of  consump- 
tives. 

tive  should  never  spit  on  the  floor  (in  fact,  no  one  ever  should) 
or  any  place  where  the  sputum  will  become  dry.  A  handker- 
chief is  perhaps  the  worst  thing  that  a  person  could  use.  It 
is  best  to  have  either  a  spittoon,  containing  some  chemical 
substance  that  will  destroy  the  bacteria,  or,  what  is  better,  tD 
have  little  paper  cups  or  napkins,  which  when  they  have  been 
used,  can  be  burned.  If  we  could  kill  all  the  germs  in  the  spu- 
tum of  those  suffering  from  tuberculosis,  the  disease  would  im- 
mediately disappear  from  the  world.  At  least  this  is  the  view 
of  a  great  many  scientists.  The  legend,  so  frequently  seen  in 
tuberculosis  literature,  NO  SPIT,  NO  TUBERCULOSIS,  voices  this 
idea,  and  is  largely  if  not  entirely  true. 


SlMIM.i:     Ll>SONS    ON     CAUSES      \\l>     I'UKVKNTInN. 


27 


It  is  possible  for  the  germs  of  1  uheivulosis  to  In-  t  i-;iiisiiiillc,l 
from  cows  to  human  beings,  particularly  children,  through  the 
milk.  This  is  generally  admitted.  In  order  not  to  get  the 
disease  hy  drinking  milk,  it  is  necessary  that  all  the  milk  sold 
on  the  market  or  used  in  the  home,  should  be  from  cattle  known 
to  he  free  from  tuberculosis.  Fortunately,  it  is  possible  readily 
31  eattle  for  tuberculosis  by  means  of  what  is  known  as  the 
"  tuberculin  test."  This  test  does  not  cost  much,  is  easily  used, 
and  is  very  accurate.  Farmers  are  finding  that  it  pays  to  have 
all  their  cattle  tested,  because  tuberculosis  in  cattle  is  as  "catch- 
ing" among  cattle  as  it  is  among  men,  and  perhaps  more  so. 
If  the  disease  once  gets  into  a  herd,  it  will  be  sure  to  spread 
and,  in  the  long  run,  produce  the  worst  results  unless  it  is 
promptly  checked. 

Mies  sometimes  help  to  spread  this  disease.  No  one  knows 
the  proportion  of  cases  that  they  cause,  but  it  is  very  important 
that  food  should  be  kept  away  from  flies.  This  ought  to  be 
done  by  Irving  first  of  all  to  limit  .the  number  of  flies  produced. 


Fig.  18. — -A  fly  on  a  pioce  of  sponge  cake.  He 
probably  came  quite  direct  from  unmention- 
able filth  in  the  neighborhood  to  the  dining 
room.  Published  in  Country  Life  in  America. 

This  can  be  done  by  caring  for  manure,  garbage,  etc.,  in  such  a 
way  that  the  flies  cannot  breed  in  these  materials.  Secondly, 
we  should  sen-en  our  houses,  and  keep  flies  out  of  the  kitchen 
and  the  dining  room,  particularly.  In  addition  to  this,  we 
should  take  especial  care  to  proteot  all  food  from  the  flies  by 


28 


TUBERCULOSIS:    OR  THE  GREAT  WHITE  PLAGUE. 


19 


Fig.  19. — Fly  tracks  on  "sterile  culture  media."  These 
covered  glass  dishes  were  first  made  sterile,  or  gmn 
free,  by  high  heat.  Wbeii  tlr.-y  were  cool  there  w;is 
poured  info  them  a  thin  layer  of  sterile  gelatin,  which 
soon  hardened. 

A  fly  was  first  allowed  to  walk  on  material  contain- 
ing a  great  many  bacteria  and  thus  get  its  feet  dirty. 
It  was  then  taken  arid  put  into  these  dishes  and  urged 
to  walk  around  in  them  each  in  turn,  twenty  in  all. 
Only  eleven  of  the  twertty  are  shown  but  the  others 
are  practically  the  same.  These  dishes  were  then  in- 
cubated for  forty-eight  hours.  The  bacteria  left  on 
the  gelatin  by  the  fly's  feet  had  in  this  time  multiplied 
to  such  an  extent  that  the  tracks  were  visible  to  the 
naked  eye,  and  appeared  as  shown  in  the  photograph 
above.  The  fly  was  killed  and  the  number  of  bac- 
teria left  on  its  feet  and  those  swallowed  was  then 
determined,  as  shown  in  the  dish  in  the  lower  right 
hand  corner. 

It  was  found  that  this  particular  flv  had  enou;?ji 
bacteria  left  on  it,  after  walking  over  all  of  the  above 
dishes,  so  that  every  man,  woman  and  child  in  the 
United  States  could  have  one  apiece,  i.  e.,  there  were 
90,000,000  bacteria  left. — Original. 


SlMI'l.i:     I.  ON    CAI   BBS      \M>     I'UKVKNTK  >N. 


29 


screening  shelves  or  other  places  for  sloping  food.  The  Iliis 
carry  on  their  feet  the  tuberculosis  g.-nii  from  sputum  <M,  the 
street,  or  in  the  gutter,  or  elsewhere.  As  they  walk  over  the 

food    they    leave    these    germs.    HHliet  illles    ill    Very    large    numbers, 

and  the  disease  is  spivad.  They  also  carry  1yj)h')id  fever  gerin^ 
and  spread  them.  In  fact,  the  common  house  fly  is  now  known 
as  the  "typhoid  fly". 

One  very  rarely  gets  tuberculosis  out-of-doors,  but  almost 
always  in  the  house,  or  iu  the  workshop.  Hence',  it  is  of  th" 
very  greatest  importance  to  have  h'>ii>es  and  workshops  most 
carefully  " disinfected"  when  people  having  cmsumption  an 
present,  and  especially  when  they  leave.  Where  peaple  having 
consumption  occupy  buildings  and  are  eareless,  these  buildings 
become  real  tuberculosis  nests,  or  breeding  places.  It  is  a  mat- 
ter of  extreme  importance1,  therefore,  when  one  moves  into  a 
house  which  other  people  have  lived  in,  to  find  out  whether  the 
disease  existed  there,  and  if  it  did  to  have  the  house  properly 
disinfected  before  going  into  it.  This  is  n  tn<t//<r  u'/iich  nmxi 
H<r<r  hr  n\'t  rl<><>l,-<  <1 .  <HK!  tm  mn  JuiriiH/  <i  ftiml'ij  in  A/x  or  licr 
<•<!>•<  should  Hinn  iitlo  <n/  inf<clt(J  house  utifil  if  lias  b«n  i>.r<>i>- 
<  /'I//  i>r<  i><tr<  <1 ,  hi/  IX'IIKJ  ntnsl  thoroughly  <'l<mi<<l  and  diviiif't  cfcd. 


Fi;.'.  L'O. 


30 


TUBERCULOSIS:   OR  THE  GREAT  WHITE  PLAGUE. 


urn  SAVERS 


LESSON  IX.    MEANS  OF  PREVENTING  TUBERCULOSIS 

(Concluded) 

In  the  last  lesson  on  the  prevention  of  tuberculosis,  the  em- 
phasis was  placed  on  the  need  of  destruction  of  the  germs  that 
leave  the  sick  person,  and  the  protection  of  the  "portals  of 
entry"  (the  mouth  and  nostrils  mainly)  to  the  bodies  of  those 
who  are  well.  Another  very  important  part  of  the  work  of 
prevention  is  the  development  and  maintenance  of  the  normal 
or  natural  vigor  of  the  body,  or  the  conservation  of  the  "health 
tone."  The  person  who  is  in  ill  health,  or  in  a  state  of  low 
vitality  for  whatever  cause,  is  much  more  liable  to  be  attacked 

by  tuberculosis,  as  well  as  by 
other  diseases,  than  is  a  per- 
son in  good  health  and  vigor. 
Among  the  things  which  may 
be  considered  as  helping  to 
cause  tuberculosis  are  certain 
kinds  of  work,  overcrowding 
in  homes,  schools,  workshops, 
etc.,  because  of  poor  ventila- 
tion, unhealthful  conditions, 
dust,  and  bad  housing  for 
these  lower  the  health  tone. 

The  frequency  of  tubercu- 
losis among  people  of  differ- 
ent occupations  has  been 
worked  out.  Laborers  and 
servants  head  the  list,  while 
farmers  and  other  outdoor 
workers  are  lowest  in  the  list. 

Where  one  is  free  to  choose  his  own  work,  it  is  worth  while, 
before  he  makes  a  selection,  to  consider  the  relative  healthful- 
ness  of  various  occupations.  It  seems  probable  that  many  kinds 
of  work  can  be  made  less  dangerous  than  they  are  now.  The 
chief  reason  why  it  has  not  been  done  in  the  past  is  because 
the  importance  of  preventing  disease  has  not  been  realized. 
The  young  people  who  are  growing  up  should  and  will  un- 
doubtedly do  much  in  this  direction.  It  is  not  merely  a  ques- 
tion of  indoor  and  outdoor  occupation,  for  some  of  the  outdoor 


HONEST  DOCTOR 
FRESH  AIR 
GOOD FOOD 
SUNLIGHMEST 
PLUCK 


Fig-  21- 


SIMPLE    LESSONS  <>.\    (1.\rsKs   AND    I'RKVKNTION.  31 

occupations  have  a  marked  influence  in  producing  ill  hcallli. 
The  accompanying  ligiiiv  will  show  thai  the  percentage  of  tu- 
berculosis among  (luarryinen  is  higher  than  it  is  among  many 
indoor  workers.  Why? 

Overcrowding  in  houses  helps  to  make  people  more  likely  to 
have  diseases,  especially  tuberculosis.  If  we  should  count  up  the 
number  of  people  who  live  in  one-room  apartments,  compared 
with  the  number  who  live  in  apartments  of  two,  three,  four,  or 
more  rooms,  we  should  find  that  there  are  not  so  very  many; 
but  if  we  should  compare  the  amount  of  sickness  and  death 
a  mo n or  those  in  the  single-room  apartments  with  the  amount 
among  those  who  have  more  room,  we  should  find  that  the  per- 
centage of  sickness  and  death  would  be  very  much  greater;  and 
anyone  who  is  obliged  to  live  in  crowded  quarters,  in  either  the 
home  or  the  workshop,  is  taking  a  much  greater  risk  of  contract- 
ing disease  than  the  people  who  have  more  space.  Many  people 
who  could  have  plenty  of  room  if  they  wanted  it  coop  themselves 
up  in  cramped  quarters  for  the  sake  of  convenience,  or  to  keep 
warm.  If  they  would  use  their  larger  space,  exercise  more,  and 
if  necessary,  spend  a  little  more  money  on  fuel,  they  would  be 
much  better  off. 

The  lack  of  fresh,  pure  air  in  the  house  or  the  workroom 
or  the  schoolroom  keeps  people  in  such  a  "run  down"  state 
that  they  are  not  the  best  workers  and  are  likely  to  take  diseases. 
Far  too  many  buildings  are  without  good  light  and  proper  mean, 
of  ventilation.  In  olden  times,  methods  of  constructing  houses 
were  much  inferior  to  the  present,  and  on  this  account  buil'd- 
ings  were  far  less  tight  than  they  are  today.  And  then,  too, 
the  method  of  heating  was  at  one  time  almost  entirely  by 
means  of  open  fireplaces.  ruder  these  conditions,  special 
means  of  ventilation  .wore  not  needed  as  they  are  at  the  present 
lime,  with  our  tight  buildings  and  our  steam  and  hot  wal'-r 
plants.  All  buildings,  where  a  number  of  people  are  working. 
should  be  provided  with  special  means  for  bringing  in  />nr< 
(tir.  The  constant  change  of  air  in  an  ordinary  living  room, 
(Called  ventilation.)  may  take  place  by  natural  means,  but  in 
larger  rooms  and  buildings,  where  there  are  a  good  many  peo- 
ple, mechanical  means  should  be  employed  to  change  the  air 
forcibly.  This  ean  bo  done  by  tlio  use  of  fans  which  drive 
pun-  air  into,  or  which  draw  the  impure  air  out  of,  a  room. 
In  Eomfc  buildings  both  systems,  forcing  in  and  drawing  out, 


32  TUBERCULOSIS:   OR  THE  GREAT  WHITE  PLAGUE. 

are  used.  Publte  buildings,  .such  as  factories,  (workshops, 
stores,  and  schoolhouses,  as  well  as  private  homes,  should  in 
these  days  be  built  around  a  good  ventilating  system,  as  they 
were  formerly  built  around  the  chimney.  In  case1  buildings 
must  be  used  without  special  means  of  ventilation,  a  great  deal 
may  be  done  by  bringing  pure  air  in  constantly  through  the' 
windows  or  other  openings. 

In  order  to  secure  a  constant  supply  of  fresh  air,  it  is  nec- 
essary to  train  the  sense  of  smell  so  that  it  will  detect  impure 
air.  We  are  likely  to  grow  careless  in  regard  to  this ;  but  any- 
one who  understands  the  importance  of  pure1  air  may  after  a 
while  become  so  sensitive  to  bad  air  that  he  will  be  uncomfort- 
able in  it.  We  sometimes  think  of  this  latter  sort  oi  person  as  a 
"crank,"  but  in  reality  he  is  very  wise,  and  we  ought  to  do  as 
he  does  and  demand  pure  air  for  our  lungs,  as  we  now  demand 
pure  food  for  our  stomachs,  and  clean  clothes  for  our  bodies. 

Our  houses  are  too  frequently  in  an  unhealthful  condition, 
due  to  the  lack  of  proper  cleaning.  This  sometimes  occurs  be- 
cause people  who  have1  charge  of  a  home  have  not  been  brought 
up  to  appreciate  that  cleanliness  is  next  to  godliness,  and  im- 
mensely important.  But  it  is  probable  that  such  persons  are 
comparatively  few.  Most  people  would  like  to  keep  their 
houses  clean,  but  on  account  of  conditions  beyond  their  con- 
trol, many  have  scarcely  the  time  or  strength  for  it.  We  can 
overcome  these  difficulties  only  by  helping  to  change  the  social 
conditions  for  such  people;  and  if  we  are  true  friends  and 
neighbors  we  can  do  a  great  deal  more  than  might  at  first  be 
thought  possible. 

Our  ways  of  cleaning  are  not  all  so  good  as  they  might  be. 
For  instance,  in  sweeping  with  a  dry  broom  we  stir  up  a  good 
deal  of  dirt  from  its  hiding  places;  much  of  this  dirt  merely 
gets  into  the  air  in  the  right  form  to  breathe.  It  is  perhaps 
true  to  say  that  dry  sweeping,  instead  of  making  a  place  more 
healthful  really  makes  it  more  dangerous.  The  same  thing  is 
true  in  regard  to  methods  of  dry  dusting.  The  feather  duster, 
or  the  dry  dustcloth  which  is  shaken  in  the  room,  is  a  very 
good  way  of  getting  dust  into  the  air,  and  of  not  getting  rid  o? 
it  properly. 

The  best  way  to  clean  is  with  a  good  "vacuum  cleaner."  By 
this  means  all  of  the  dirt  is  taken  out  of  the  house  without  stir- 
ring up  dust.  There  are,  however,  some  of  the  cheaper  cleaners 


LESSONS  <>\   CAUSES    \\D  PREVENTION.  33 

which  throw  the  dirt  hack  into  the  rconi,  mid  these,  like  the 
broom,  must  he  considered  as  enemies  of  health.  Where  vacuum 
cleaners  ,-ire  not  possible,  a  carpet  sweeper  may  be  used,  or  some- 
thing may  lie  put  on  the  floor,  such  as  wet  strips  of  paper,  tea 
leaves.  01-  some  of  the  prepared  "dust-layers."  For  dusting, 
special  cloths  may  he  bought  or  prepared  which  hold  the  dirt,  or 
a  <l<niii>  cloth  may  be  used. 

Many  houses  are  built  over  damp  and  dirty  cellars.  Ther'3 
is  no  excuse  for  a  dirty  cellar.  If  only  one  place  in  the  house 
can  be  clean,  it  should  be  the  cellar.  Let  the'  parlor  go  dirty, 
it'  you  must,  but  clean  the  cellar.  Too  often  the  cellars  and 
halls  in  apartment  houses  are  not  properly  cleaned,  because  no 
inn  person  has  complete  control  of  them.  They  are  neglected 
on  the  principle  of  ''Everyone's  business  is  nobody's  business/' 
Damp  cellars  are'  very  generally  regarded  as  unhealthful.  Few 
landlords  would  be  willing  to  live  over  damp  cellars  themselves, 
and  no  landlord  ought  to  be  permitted  to  allow  his  tenants  to 
live  in  such  surroundings.  In  these  days  when  cement  is  so 
cheap  and  so  generally  used,  there  seems  no  excuse  for  it. 
What  we  need  is  merely  an  aroused  public  opinion. 

Sometimes  houses  are  well  kept  inside,  but  have  dirty  and 
unsanitary  back  yards.  The  back  yard  ought  to  be  as  clean  as 
the  front  yard,  and  some  means  of  taking  care  of  the  necessary 
refuse  about  any  building  should  be  provided.  The  method  of 
hanging  bags  so  that  they  can  be  readily  filled  with  old  paper, 
and  tin  cans  is  excellent.  Garbage  should  also  be  carefully  taken 
care  of.  In  the  city  where  it  is  collected  it  is  important  to  have 
cans  or  boxes  for  it  properly  protected  from  flies.  Where  the 
garbage  must  be  cared  for  on  the  place,  this  can  be  done  by 
burying  it  or  burning  it. 

Another  thing  that  should  be  especially  attended  to  about  the 
house,  or  any  building  for  that  matter,  and  perhaps  especially 
the  school,  is  the  plumbing.  Defective  plumbing  allows  the  es- 
cape of  <rases  and  odors  into  the  room  and  these  are  generally 
considered  to  he  important  means  of  lowering  the  "health  tone." 

In  considering  matters  of  this  kind,   it  is  worth   calling  to 
mind  the  words  of  Longfellow  in  his  "Builders:" 
"In  the  elder  days  of  Art, 

Builders  wrought  with  greatest  care 
Each    minute    and   unseen   part; 
For  the  Gods  see  everywhere. 


34  TUBERCULOSIS:   OR  THE  GREAT  WHITE  PLAGUE. 

Let  us  do  our  work  as  well, 
Both  the  unseen  and  the  seen; 

Make  the  house  where  Gods  may  dwell, 
Beautiful,  entire,  and  clean." 


Fig.  22. — A  dust  storm.  May  disease 
irerms  be  spread  by  such  storms? 
How?  Will  -  oiling  streets  prevent 
this? 

Dust,  either  inside  or  outside  of  the  house  or  school  building, 
when  breathed  into  the  lungs,  is  harmful.  It  undoubtedly  is 
the  cause  of  disease,  and  especially  of  diseases  of  the  lungs, 
such  as  consumption.  Some  kinds  of  dust  are  much  more  irritat- 
ing, and  so  more  harmful,  than  others.  Metallic  dust,  especially 
when  the  particles  have  sharp,  cutting  edges,  is  likely  to  be  very 
injurious;  the  dust  caused  in  making  knives  and  forks,  etc., 
is  very  bad  for  the  health.  Other  dusts  are  not  so  bad,  but 
they  may  cause  serious  changes  in  the  lungs.  Hard  dust,  such 
as  that  produced  by  working  on  stone,  is  likely  to  be  harmful. 
Coal  dust  acts  much  in  the  same  way.  When  these  little  particles 
of  dust  are  breathed  in,  they  make  their  way  from  the  air  cells 
to  certain  parts  of  the  lungs,  where  they  gather  in  large  numbers. 
They  are  carried  to  these  tissues  by  the  white  blood  corpuscles. 
The  effect  of  the  gathering  of  these  particles  in  the  lungs  Is 
the  most  easily  seen  where  coal  dust  is  breathed  in;  and  if  it 
were  possible  for  us  to  see  the  lungs  of  those  who  handle  coal, 
and  those  who  live  in  big  cities,  especially  where  a  great  deal 
of  soft  coal  is  burned,  we  should  notice  that  parts  of  the  lungs 
were  coal  black  in  color,  and  in  this  respect  would  be  very  dif- 
ferent from  the  lungs  of  a  person  who  had  always  lived  in  the 
free,  open  country.  The  bad  effects  of  the  constant  breathing 


SIMM  ON     CAUSES     \M> 


35 


of  dust-laden  air  arc  easily  shown  when-  the  death  rate  from  con- 
sumption in  different  occupations  is  studied. 

Tln»  li«rlilin«r  of  ;i  house  is  a  matter  of  no  small  importance. 
Houses  ought  to  be  so  arranged  that  the  sunlight  will  enter 
through  at  least  one  window,  in  every  room  during  the  course 
of  the  day.  T!IOM>  rooms  that  arc  Ihe  most  used  should  bo 
tin-  best  lijrhlrd.  It  is  important,  then,  to  build  houses  with 
iviVrniee  to  the  lighting.  It  is  not  at  all  necessary  that  a 


Fi;r.  -•">. —  Individual  towel  distributor  in  use  at  the 
I'nivcrsity  of  Wisconsin.  The  towels  are  small 
:ind  n  fresh  one  is  always  ready  for  use.  Why  is 
this  a  good  arrangement? 


house  should  face  the  street,  and  many  houses  are  now  built 
facing  a  beautiful  outlook.  Houses  ought  always  to  be  faced 
with  reference  to  the  sunlight.  The  size  and  arrangement  of  the 
windows  should  depend  upon  what  is  the  most  healthful  and 
not  upon  what  looks  best,  although  it  is  generally  true  that 
houses  can  be  suitable  to  live  in  and  beautiful  to  look  at,  at  the 
same  time.  The  amount  of  window  space  in  a  room  should  be  at 
least  one-fifth  of  the  floor  spac* . 


TUBERCULOSIS:    OR  THE  GREAT  WHITE  PLAGUE. 


Fiii-.  24. — A  sanitary  bubble  drinking 
fountain.  Is  this'  bettor  than  usirii 
a  common  drinking  cup?  Why? 


The  necessity  for  light  in 
buildings  was  .realized  long 
before  the  real  reason  was 
discovered.  There  is  an 
Italian  proverb  that  says, 
' '  Where  sunlight  does  not  en- 
ter, the  physician  does."  Ony 
reason,  at  least,  why  this  i; 
true,  is  that  the  sunlight  killi 
the  disease  germs.  Sunlight 
is,  as  we  say,  a  good  "germi- 
cide," or  germ-killer.  In 
building  a  house,  the  first 
thing  to  be  thought  of  should 
lie  the  effect  which  the  loca- 
tion and  arrangement  would 
have  upon  the  health  of  those 
who  are  to  live  in  it.  It  is 
not  enough,  however,  to  have 

properly  constructed  buildings.  They  must  be  sensibly  used. 
Windows  are  of  little  use  if  the  shades  are  always  drawn,  or  the 
blinds  are  always  closed.  A  large  bedroom  or  living-room  may 
easily  be  overcrowded.  Sometimes  people,  who  have  all  the 
room  they  need,  live  in  a  little  ill-smelling  kitchen  in  the  day- 
time, and  a  stuffy,  foul  bedroom  at  night.  These  people,  of 
course,  do  not  realize  how  bad  such  a  life  is  for  themselves  and 
their  children.  There  are  many  things  worse  for  health  than 
being  cold — for  instance,  being  overcrowded,  and  having  too 
little  pure,  fresh  air,  and  bright,  life-giving  sunshine. 

It  is  sometimes  supposed  that  these  ills  which  we  have  been 
talking  about  are  found  only  in  the  city,  but  this  is  not  true. 
Housing  conditions  are  often  as  bad  in  the1  country  as  they 
are  in  the  city.  It  is  true1  that  in  the  country  there  is  plenty 
of  pure  air  and  bright  sunshine,  and  frequently  the  house? 
are  large  enough ;  but  the  people  are  likely  to  be  overcrowded 
in  certain  rooms,  as  the  kitchen  and  sleeping  rooms,  for  short: 
periods  of  time  in  the  summer,  and  long  periods  in  winter. 
The  desire  to  save  money  has  led  people  to  be  careless  about 
healthful  conditions;  and  small  rooms  are  frequently  built  and 
used  because  they  do  not  require  much  fuel  for  heating.  This  is  a 
poor  way  of  saving,  as  people  would  readily  understand  if  they 
stopped  to  think  of  the  matter.  The  cost  of  a  doctor's  bill  and 


SI.MI-I.I-:    LESSONS   ON    CAUSES    \ND    IY-HNKNTIUN.  -'!7 

perhaps  ;i    I'linen-il    limy  e;isily   more  tliim   offset    the  "saving"   ill 
fuel  ,-iii(l  sufficient  room. 


Fi-r.   L."..      A    sanitary    ennkinu-  !'ount;iin    is   possible    wherever 
lli'Tv    is   a   well. 

THE  FENCE  OR  THE  AMIK'I.AXCE. 
Twas  a  dangerous  cliff,  as  they  freely  confessed, 

Though  to  walk  near  its  crest  was  so  pleasant, 
But  over  its  terrible  edge  there  had  slipped 

A  Duke  and  full  many  a  peasant. 
So  the  people  said  something  would  have  to  he  done, 

But  their  projects  did  net  at  all  tally. 
Some  said,  "Put  a  fence  round  the  edge  of  the  cliff," 

Some,  "An  ambulance  down  in  the  valley." 

But  the  cry  for  the  ambulance  carried  the  day, 

For  it  spread  through  the  neighboring  city; 
A  fence  may  be  useful  or  not,  it  is  true, 

But  each  heart  was  brimful  of  pity 
For  those  who  slipped  over  the  dangerous  cliff; 

And  the  dwellers  in  highway  and  valley 
Gave  pound  or  gave  pence,  net  to  put  up  a  fence. 

But  an  ambulance  down  in  the  valley. 

"For  the  cliff  is  all  right  if  you're  careful,"  th?y  said, 

"And  if  folks  even  slip  or  are  dropping, 
It  isn't  the  slipping  that  hurts  them  so  much 

As  tho  shock  down  below  when  they're  stopping." 

Then  an  old  sage  remarked:     "It's  a  marvel  to  me 

That  people  give  far   more   attention 
To  repairing  results  than  to  stepping  tho  cause, 

When  they'd  much  better  aim  at  prevention." 

"Let  us  stop  at  its  source  all  this   mischief."   ciied   he 

"Come,  neignoors  and  friends,  let   us   rally. 
If  the  cliff  we  will  fence,  we  might  almost  disnsnse 

With  the  ambulance  down  in  the  v;ill:  jr." 
"Oh.  he's  a  fanatic."  the  others  rejoined. 

"Dispense  with  the  ambulance?     N< 
He'd  dispense  with  all  charities,  too,  if  he  cruM; 

But,  no!     We'll  protect  them  forever! 

"Aren't  we  picking  up  folks  just  as  fast  as  they  fall? 

And  shall  this  man  dictate  to  us?     Shall  he? 
Why  should  people  of  sense  stop  to  put  up  a  fence 

While  their  ambulance  works  in  the  valley?" 


38 


TUBERCULOSIS:    OR  THE  GREAT  WHITE  PLAGUE. 


LESSON  X.    DEVELOPING  RESISTANCE  TO  DISEASE. 

One  of  the  most  remarkable  things  in  all  the  world,  so  the 
scientist  thinks,  is  the  fact  that  certain  animals  are  ' '  resistant, ' ' 
or  "immune,"  to  a  disease,  while  other  animals  differing  very 
slightly  take  the  disease  readily:  e.  g.,  the  house  mouse  is  im- 
mune to  glanders,  a  disease  common  among  horses,  while  the 
field  mouse  is  extremely  susceptible.  The  rat  is  immune  to 
many  germs  which  attack  his  near  relatives.  Differences  of  the 
same  kind  are  seen  in  man.  Some  races  take  diseases  more 
easily  than  others ;  and  everyone  knows  families  that  are  always 
sick,  whose  members  take  every  "catching"  disease  that  is 
about ;  while  other  families  in  the  same  community  are  well  and 
strong,  and  almost  always  escape  the  ordinary  diseases.  The 
same  thing  is  true  of  persons;  some  people  are  very  suscepti- 
ble to  disease,  and  in  later  years  speak  with  apparent  pride  of 
the  fact  that  they  have  themselves  had  all  of  the  ordinary  dis- 
eases. 

Scientists  are  not  agreed  as  to  the  reason  for  this  difference 
between  individuals.  "Immunity"  may  be  handed  down  from 
one  generation  to  another  in  the  family.  Perhaps,  also,  a  per- 
son may  inherit  a  readiness  to  "catch"  a  disease.  We  do  not 
know  whether  this  is  true  or  not,  but  we  do  know  that  surround- 
ings, habits,  and  even  ways  of  thinking  do  have  a  marked  influ- 
ence upon  the  disease  resistance  or  susceptibility  of  a  person. 


Fig.    26. — Plenty    of   fresh   air. 


Fig.  27. — Fresh  air  at  night.  "Night 
air  is  not  dangerous  unless  it  be 
last  night's  air." 


SI.MIM.I-:  LESSONS 


CAUSES   AND   I'KI:\  KNTION. 


Kb.    29.— Healthy    exercise. 


Fi-.    js.      Kvm    tho    littlo    fellows    enjoy 
the    winter    hikes. 


In  order  to  escape  disease  one  must  have  healthful  surround- 
ings. This  does  not  mean  <h(/<inl  surroundings.  In  fact,  the 
life  of  the  rich  is  quite  as  likely  to  lead  to  ill  health  as  the  life 
of  the  very  poor.  What  is  really  need.ed  is  for  all  of  us  to 
live  a  simple,  wholesome  life;  and  it  is  easily  possible  for  almost 
any  one.  even  though  he  he  poor,  to  keep  his  surroundings  so 
healthful  that  they  can  not  do  him  any  injury.  This  may  neces- 
sitate moving  from  one  house  into  another;  or  changing  the  rooms 
in  one's  house,  changing  the  way  one  divides  his  time  for  work 
and  play,  or  the  like;  but  these  things  could  be  done  if  the  neces- 
sity for  them  were  really  felt.  A  good  many  things  necessary  to 
be  done  depend  upon  many  persons  doing  them  together;  but 
first,  people  have  to  be  shown  that  such  things  are  necessary.  A 
<:reat  many  people  do  not  know  that  tuberculosis  is  a  germ  dis- 
ease which  is  "catching"  and  do  not  therefore  see  how  necessary 
it  is  to  take  care  of  the  sputum,  to  disinfect,  etc.  No  child  is  so 
small  that  he  cannot  help  to  teach  people  to  be  careful  about 
tuberculosis.  Children  ought  to  take  pride  in  work  <,?  this 
kind,  just  as  they  take  pride  in  succeeding  in  their  school  work, 
or  in  their  games. 

In  order  to  keep  well,  one  must  have  plenty  of  pure  air. 
We  may  speak  of  this  again  so  as  to  impress  it.  Health  experts 
are  quite  agreed  now  that  fresh  air  is  very  important  in  prevent- 
ing tuberculosis  as  well  as  pneumonia,  and  certain  less 
fatal  diseases,  such  as  influenza  (or  grippe)  and  colds.  Every- 
one ought  to  have  fresh  air  in  abundance  while  he  sleeps.  At 


40  TUBERCULOSIS:   OB  THE  GREAT  WHITE  PLAGUE. 

the  present  time  evidence  seems  to  point  very  conclusively  to  the 
desirability  of  sleeping  out-of-doors.  If  this  cannot  be  done, 
the  bedrooms  should  have  several  windows,  and  they  should  be 
kept  open — fully  in  mild  weather,  and  sufficiently  in  cold 
weather  to  insure  the  frequent  change  of  air  in  the  room.  Dur- 
ing the  day,  whether  at  home,  in  the  schoolhouse,  or  at  work, 
everyone  ought  to  insist  on  a  good  supply  of  fresh  air.  The 
one  who  does  this  has  an  advantage  over  the  one  who  does  not ; 
and  the  former  can  resist  disease  which  may  attack  and  con 
quer  the  latter. 

In  order  to  keep  well  one  must  also  have  wholesome  food, 
properly  cooked,  regularly  eaten,  and  completely  digested. 
Most  people  can  get  plenty  of  good  food  nowadays;  and  if 
they  do  not  know  how  to  cook  it,  there  are  many  ways  by  which 
they  can  learn.  In  most  cities  there  are  cooking  classes.  The 
United  States  Government  also  publishes  bulletins  which  are 
of  great  value.  It  frequently  happens  that  people  suffer  from 
sickness  caused  by  bad  habits  of  eating,  such  as  not  chewing 
enough,  eating  too  much  candy,  eating  between  meals,  always 
eating  soft  foods,  and  so  on.  When  such  sickness  is  severe,  a 
doctor  should  be  consulted.  It  is  better  to  pay  a  small  fee  to 
a  doctor  who  can  tell  you  hew  to  live  than  it  is  to  pay  him 
later  for  work  done  at  your  bedside.  But  don't  take  patent 
medicines,  whatever  you  do.  Many  people  are  ailing  much  of 
the  time  because  they  are  constantly  swallowing  patent  medi- 
cines. 

If  one  would  escape  illness  he  must  be  careful  of  his  exercise. 
Children  do  not  usually  need  to  be  urged  to  take  exercise,  but 
they  do  need  to  be  warned  against  too  much  exercise.  There 
is  great  danger  .of  taking  "cold"  after  violent  exercise,  and 
children  ought  early  to  learn  how  to  protect  themselves  from 
colds,  especially  those  colds  that  come  from  cooling  off  too 
fast  when  one  has  been  working  or  playing  very  hard.  Colds 
do  not  "just  happen;"  they  have  a  cause.  Colds  are  often 
caused  by  the  sudden  chilling  of  some  part  of  the  body,  causinj 
the  blood  which  is  usually  at  this  part  to  rush  to  the  nose  and 
throat,  resulting  in  a  congestion  there. 

Colds  are  also  caused  by  microbes,  and  such  colds  are  passed 
on  from  one  person  to  another.  One  should  keep  away  from 
people  suffering  from  colds,  especially  colds  of  a  "grippy"  na- 
ture. Colds  in  themselves  are  not  usually  considered  serious, 


SI.MI-I.I:    LESSONS   »N    ( 


KX  I:.\TI<>\. 


41 


luit  when  we  remeinher  the  inconvenience  and  suffering 
they  produce,  and  the  loss  of  time  and  energy  which  they  cause 
we  can  see  that  there  is  hardly  anything  nmiv  important.  Be- 
sides this,  they  have  an  influence  in  making  people  more  likely 
t«»  lake  dise.-is.-s.  We  very  frequently  hear  people  talk  atiout 
a  cold  runninir  into  this  disease  or  that  disease;  but  this  is 
not  true,  as  tuberculosis,  for  instance,  never  comes  from  a  cold, 
and  never  follows  a  cold,  iinlc-M  the  y<.rm  of  hilx  rctdusi*  is  pres- 
ent. However,  colds  sometimes  do  make  people  so  weak  that 
they  easily  take  tuberculosis,  as  well  as  other  infectious  diseases. 

The  protection  of  the  body  is  also  a  matter  of  very  great 
importance  for  one's  health.  A  person  ought  to  wear  the  right 
amount  of  clothing,  suited  to  the  season.  Too  much  is  as  dan- 
gerous as  too  little.  If  one  wears  too  little  clothing,  the  vigor 
of  the  body  is  likely  to  be  lessened;  and  the  same  is  true  if  the 
clothing  is  too  thick.  Children,  especially,  are  likely  to  object 
to  wearing  extra  clothing,  or  "bundling  up"  even  when  it  is 
absolutely  necessary,  because  it  interferes  with  their  movements 
or  their  convenience.  But  they  must  remember  that  the  tmiin- 
h  i, it  nee  of  health  is  the  most  important  thing  in  the  world  h, 
UK  HI.  and  if  they  do  not  preserve  their  health  they  will  bring 
upon  themselves  bodily  suffering,  and  bring  to  their  relatives  and 
friends  care  and  anxiety  without  measure.  The  necessity  for 
this  care  has  been  taught  by  the  experience  of  the  race.  Why 
do  children  persist  in  going  out  without  their  rubbers  when 
they  know  that  they  will  get  their  feet  wet?  Why  do  they  re- 
fuse to  wear  an  overcoat  or  mittens  which  they  need? 

One  should  get  into  the  habit  of  looking  out  for  his  health ; 
in  order  to  do  this  he  ought  to  consider  the  following  rules: 


*  « 

A  ^^          f*  ^^  *    *^^ 

J'  -VJrf 


Fi.ir.    :;n .—  Cirls    ns    well     ns    boys    noocl      Fijr.   .°.l.— Liltlo   children   love    the  "out- 
tli.^    "out-of-door"'    exercise.  of-doors."     It    is   their   best   friend. 


42  TUBERCOLISIS  :  OR  THE  GREAT  WHITE  PLAGUE. 

RULES   OF    HEALTH.* 

1.  When  you  arise  in  the  morning  throw  the  bedding  over 
the  foot  of  the  bed  so  that  the  bedclothes  may  have  a  chance 
to  air. 

2.  Close  the  window  that  has  been  open  during  the  night  if 
.you  are  to  dress  in  the  same  room.     Otherwise  it  is  not  neces- 
sary. 

3.  Cleanse  the  teeth,  especially  the   places  that  are  out  of 
sight  and  hard  to  reach. 

4.  If  you  have  time,  bathe  all  over   (finishing,  if  not  begin- 
ning, with  cold  water).     If  it  is  not  possible  to  bathe  all  over, 
bathe  the  face,  neck,  and  chest,  and  particularly  the  eyes,  ears 
and  nose. 

5.  Clean  the  finger  nails.     This  should  become  a  fixed  habit. 

6.  Drink  a  glass  of  water.     This  is  a  good  habit  to  form,  and 
it  seems  to  aid  digestion. 

7.  Eat  breakfast  at  a  regular  hour.     Eat  only  what  agrees 
with  you.    Make  an  effort  to  be  cheerful  at  meals. 

8.  Visit  the  toilet,  if  practicable,  at  home.     Have  some  reg- 
ular time  during  the  day. 

9.  Spend  as  much  time  in  the  open  air  as  possible.     Create 
#n  interest  in  nature.     Make  friends  with  sky,  birds,  flowers, 
trees  and  animals,  and  be  attentive  and  true  to  them. 

10.  Be  punctual  in   all  of  your  duties  both   in   and  out  of 
school. 

11.  Try  to  have  a  supply  of  fresh  air  wherever  you  are,  and 
-demand  this  with  the  same  emphasis  that  you  use  in  demanding 
sufficient  heat  in  cold  weather.     Do  not  be  afraid  to  say:  "I 
need  fresh  air." 


*  Adapted  from  Alle'n  in  "Civics  and  Health." 


Fi"-.  -°>2. — Dry  feet,  fresh  air,  and  plenty 
of  sleep  help  to  keep  up  the  power 
of  the  body  to  kill  germs.  From 
Ritchie's  Hygiene  published  by  the 
World  Pub.  Co. 


SIMPLE   LKSSUXS  ON  CAUSES  AND  PREVENTION.  43 

1:2.  Mat  punctually  at  noon.  Take  time  and  enjoy  your  meal 
and  its  effects. 

!-">.  I'.ivatlir  air  out-of-doors  as  long  as  possible,  in  walking 
and  playing  lightly. 

14.  Resume  your  duties  punctually. 

!.">.  Stop  work  regularly  and  promptly. 

16.  Take  out-of-door  exercise — indoor,   only  when   fresh   air 
is  possible — that  you  enjoy  and  which  agrees  with  you.     If  you 
get  "sweaty"  in  playing, — when  you  stop  put  on  extra  clothes 
or  go  into  the  house.     Do  not  court  a  cold. 

Be  especially  careful  to  keep  your  feet  dry.  If  you  cannot 
help  getting  them  wet,  make  every  effort  to  change  your 
footwear  or  to  dry  it  out  promptly.  To  take  care  of  yourself  and 
I  in  serve  your  health  is  most  important.  It  is  not  a  cowardly 
tiling  to  do.  It  is  the  most  important  and  manly  or  womanly 
tlnng  yon  can  possibly  do. 

17.  Eat  your  evening  meal  at  a  fixed  time,  and  do  not  hurry 
with  it  nor  eat  too  much;  eat  nothing  that  disagrees  with  you. 

18.  Spend  the  evening  pleasantly  in  ways  that  are  in  keep- 
ing with  the  foregoing  habits. 

19.  Go  to  bed  regularly  at  a  fixed  hour;  make  up  for  any  ir- 
regularity one  night  by  an  earlier  hour  the  next  night. 

20.  21,  22.     Repeat  4,  6,  8. 

23.  Turn  your  underclothes  wrong  side  out  for  ventilation. 

24.  Open  the  windows,  or  sleep  out-of-doors  if  possible. 

25.  Relax  your  mind  and  body  and  go  to  sleep. 
Suggestions  for  some  practical  work  are  here  proposed. 

A  grown-up  person  requires  about  three  thousand  cubic  feet 
of  air  every  hour.  When  the  necessary  ventilation  is  secured, 
the  required  cubic  contents  can  be  reduced  to  two  thousand 
cubic  feet  or  less.  In  most  homes  forced  ventilation  is  not 
provided  for.  Figure  out  the  number  of  cubic  feet  in  your  liv 
ing  room  and  divide  it  by  the  number  of  persons  who  are  us- 
ually there.  Do  you  have  the  required  amount  of  air  in  your 
living  room? 

In  the  same  way  find  out  the  air  space  in  your  bedroom,  and 
the  amount  of  air  for  each  person  in  it. 

Do  you  sleep  with  your  bedroom  window  open  ?     How  wide  ?* 


*  The  teacher  should  be  careful  not  to  make  public  comparisons 
which  will  hurt  the  feelings  of  sensitive  children  whose  home'  condi- 
tions are  poor  because  of  poverty,  sickness,  or  the  like. 


44 


TUBERCULOSIS:   OR  THE  GREAT  WHITE  PLAGUE. 


Since  a  room  ought  to  have  window  space  equal  to  on?-fifth  of 
the  floor  space.  Find  out  the  size  of  the  floor  in  your  living 
room  and  then  determine  the  area  of  the  window  space.  Have 
you  as  much  light  as  you  ought  to  have?  Do  the  same  thing 
for  your  bedroom. 

Dees  the  s;m  shine  directly 

into  your  living  room  and 
bedroom?  For  how  many 
hours  every  day? 

How  much  space  is  there 
between  your  own  and  your 
neighbor's  house? 

Does  the  teacher  keep  the 
window  curtains  drawn  down 
over  the  top  part  of  the  win- 
dow? Unless  the  sun  is  shin- 
ing into  the  room  through  the 
window,  the  curtains  should 
be  rolled  up  to  the  top.  The 
room  is  lighted  mainly  from 
the  upper  part  of  the  win- 
dow. If  you  get  water  for 
school  uses  from  a  well,  is  the 
well  carefully  pumped  out 
and  cleaned  before  school  be- 
gins in  the  fall?  It  should 
be  covered  so  that  dirty  water  cannot  possibly  run  into  it,  and 
so  that  mice  and  other  small  animals  cannot  fall  into  it. 

School  authorities  should  provide  seats  in  the  schoolroom 
suited  to  the  size  of  the  children,  so  their  feet  rest  on  the  floor, 
and  so  they  do  not  have  to  stoop  over  when  they  sit  at  the  desk, 
or  twist  themselves  out  of  shape  because  the  desk  is  too  high. 
In  other  words  have  the  seat,  desk  and  child  properly  matched. 

If  you  live  in  the  country,  has  the  school  a  ventilating  stove 
that  brings  in  fresh  air?  Is  there  an  outlet  for  bad  air?  If 
not,  why  not? 


Fiir.    33. — A    hike    through    the    woods. 
There   is   plenty   of    fresh   air   here. 


SI.MI-I.I:    LESSONS   «»N    CAUSES    AND    I'I;KVI-:.\TK»N. 


45 


LESSON  XI.    TUBERCULOSIS  A  CURABLE  DISEASE. 

Our  ideas  of  tin-  possibility  of  curing  tuberculosis  have  I-«M-M 
<-h;nip-(l  a  good  deal  in  the  last  few  years.  People  once  be- 
lieved that  tuberculosis  was  incurable;  and  to  tell  a  person  that 
lie  was  afllii-tod  with  the  dread  malady  was  like  reading  his  death 
warrant  to  him.  Today  we  look  upon  the  disease  in  quite  n 
tiitlVivnt  light.  It  is  curable.  This  change  in  our  views  has 
n  i  come  about,  however,  because  of  the  discovery  of  some  new7 


I''-.    '!»-      <  'i;t  of-door    school    for    tubercular    children — fresh    air — open    minds. 

medicine,  for  it  still  remains  true  that  wre  do  not  know  of  any 
specific  for  this  disease.  Quacks  and  patent  medicines  cause 
much  real  suffering,  because  victims  are  made  to  think  that 
they  can  be  helped  by  some  skillfully  advertised  medicine  or 
"cure,"  which  is  really  not  going  to  give  the  expected  relief, 
but  which  is  almost  certain  to  delay  honest  and  helpful  treat- 
ment until  the  case  is  beyond  help.  Remember  that  the  mod- 
ern treatment  of  tuberculosis  requires  open  air,  rest,  and  food. 
It  would  be  difficult  to  explain  just  why  it  is  that  out-of- 
door  air  is  better  than  the  air  of  dwellings,  but'  there  is  abun- 


46  TUBERCULOSIS:   OR  THE  GREAT  WHITE  PLAGUE. 

dant  evidence  to  show  that  this  is  true.  A  tubercular  patient 
should  ~be  in  the  open  air  practically  all  of  the  time,  day  and 
night}  summer  and  winter.  That  cold  air  is  not  harmful,  but  in 
reality  helpful,  is  shown  by  a  saying  in  the  Adirondacks,  gen- 
erally accepted  as  true,  that  "One  winter  is  worth  two  sum- 
mers." Are  you  in  as  good  health  in  winter  as  in  summer? 
Whatever  your  answer  is,  say  why.  Where  and  what  are  the 
Adirondacks? 

Another  necessary  requirement  is  rest.  When  there  is  fever, 
especially,  it  is  absolutely  necessary  that  there  should  be  rest, 
complete  rest,  and  to  this  end  the  patient  must  occupy  the  bed 
and  lounging  chair  constantly.  The  slight  amount  of  exercise 
necessary  must  be  taken  a  little  at  a  time,  so  as  not  to  overtax 
the  strength.  It  is  quite  impossible  for  tubercular  patients  to 
work  hard  and  at  the  same  time  take  the  proper  care  of  them- 
selves. The  third  thing  necessary  is  plenty  of  food,  especially 
proteid  food,  such  as  meat,  eggs  and  milk. 

Climate  is  not  now  considered  a  very  important  matter  in  the 
treatment  of  tuberculosis.  By  this  is  meant  that  tuberculosis 
can  be  cured  in  almost  all  climates,  and  many  persons  cannnt 
afford  to  go  to  some  other  climate.  It  seems  best,  therefore,  to 


-±_____ J 

Fig.    .°>r>.— A    Sanatorium   for  the  treatment   of  tuberculosis.     Here   the   patients 
have   fresh  air  day  and  night. 


SIMPLE  LESSONS  ON  CAUSES 


lie.-it  tuberculosis  .-it  home  or  in  "s;m«it<  niims"  close  by.  Note 
the  nrnmiremeiits  for  treatment  in  tin-  accompanying  pictures- 
of  sanatoriums. 

The  cure  for  tuberculosis  is  really  only  a  healthful  way  of 
lirint/,  and  the  more  nearly  one  holds  himself  to  the  rules  the 
better  are  the  chances  for  recovery.  This  is  borne  out  by  the 
fact  that  patients  in  prisons  make  the  highest  percentage  of  re- 
coveries. soldiers  next,  and  persons  in  ordinary  life  last  of  all. 
AVliy,  do  you  think? 

Look  up  in  the  dictionary  the  meaning  of  the  words  sanitarium 
nnd  sanatorium. 

AVhere  is  the  Wisconsin  State  Sanatorium  for  tuberculosis  f 

Tell  what  railroads,  or  other  means  of  conveyance,  you  would 
have  to  take  to  get  there,  and  what  the  probable  cost  would  be. 

Do  you  know  anyone  who  has  ever  boon  there?  If  so,  get 
him  to  tell  you  about  the  life  there. 

If  you  sleep  out-of-doors,  tell  how  the  bed  is  arranged  and 
the  amount  of  clothing  which  you  use.  If  you  do  not  now 
sleep  out-of-doors  find  out  the  best  way  to  arrange  for  doing  it. 
Find  out  the  amount  of  bedding  which  you  would  need.  What 
would  be  the  cost  of  a  tent  in  which  you  might  sleep  all  sum- 
mer?* 


*  Teachers  might  find  it  profitable  to  have  i  little  exhibit  illus- 
trating tuberculosis  or  hygiene.  Miss  Goldie  Whipple,  of  Superior, 
Wisconsin,  prepared  such  an  exhibit  which  was  sent  to  the  Interna- 
tional Congress  on  Tuberculosis  at  Washington  and  attracted  wide 
attention. 

Boys  could  be  asked  to  make  a  model  of  a  sanitary  tent  with  floor 
and  means  of  ventilation.  Girls  could  make  a  small  model  of  a 
sleeping  bed  or  a  hood  and  dress  up  a  doll  to  show  the  way  the 
clothes  should  be  arranged  for  out-door  sleeping. 

Charts  could  be  prepared  and  pictures  from  bulletins  mounted  so 
as  to  make  a  very  creditable  showing.  They  could  be  arranged  to- 
show  that  tuberculosis  is  a  communicable,  a  preventable,  and  a  cur- 
able disease. 

—Comforters 
-Blankets 
1  Cotton 

—Bed  pad 
— Second  mat  IP 
-  I'aper       .blankets 
sheets 

—Mattress 


—Springs 


Fi-.    ."JO — This  shows  how   a  bed   should   bo   made  up 
for    out-of-door    use. 


,..„,.  —  „._.,.„.,  _,—...,.....,.  

-1 

~^f   ^f  ^if- 

T^M]'i;<'ri.,>s<s:.  OR  THE  GREAT  WHITE  PLAGUE. 


Fig.    37. — This   little  family   is   ready   for   bed. 


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n 


OCT  10 1932 
OCT   I0t93fc 

APR  9     194: 

'JUL  19 

JUL  181949 
y  2  8  1949 


0V 
NOV  6 


1951 


APR  2  2  'i960 
AP20'60JM 


APR  2  4  1963 


OCT  261964 

GCT23  J964 
APR  1?  1968 

S 


14  DAY  USE 

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TEL.  NO.  642-2532 

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